Ectopic pregnancy at the Lagos University Teaching Hospital, Lagos, South-Western Nigeria: Temporal trends, clinical presentation and management outcomes from 2005 to 2014

Olamijulo, Joseph Ayodeji; Okusanya, Babasola O; Adenekan, Muisi A; Ugwu, Aloy Okechukwu; Olorunfemi, Gbenga; Okojie, Osemen Ehidiamen

doi:10.4103/npmj.npmj_35_20

Cited by 10 publications

(6 citation statements)

References 1 publication

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“…The implantation of fertilized eggs in the cervix is often unstable, and most patients with cervical pregnancy abort within 20 weeks of pregnancy [ 14 , 15 ]. There are abundant blood vessels around the gestational sac, and the embryo will increase its vitality as the gestational age increases, thereby increasing the risk of miscarriage and hemorrhage in patients with cervical pregnancy [ 16 , 17 ].…”

Section: Discussionmentioning

confidence: 99%

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Gong¹,

Qian

Zhang³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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This is a retrospective study to analyze the efficacy of uterine artery chemoembolization (UACE) combined with ultrasound-guided curettage in the treatment of cervical pregnancy and the factors affecting the postoperative outcome. A total of 26 subjects were included in the study and were divided into a control group of 12 and an observer group of 14, all patients with cervical pregnancy diagnosed in our hospital from January 2016 to January 2020. Patients in the control group were treated with methotrexate injection (MTX) combined with ultrasound-guided curettage in our hospital, while the observer group was treated with UACE combined with ultrasound-guided curettage. The efficacy of the two groups was evaluated at 3 months postoperatively, and data on patients’ age, days of menopause, pregnancy frequency, and vaginal bleeding were collected retrospectively. Intraoperative bleeding, time to recovery of serum human chorionic gonadotropin (HCG), hospitalization time, time to return to normal menstruation, time to disappearance of gestational sac, pregnancy frequency, presence of endometrial inflammation, gestational week, maximum diameter of gestational sac, thinnest myometrium, endogenous-exogenous type, gestational sac size, and HCG level were recorded in both groups. Single-factor analysis and multifactor logistic regression models were used to analyze the factors influencing the surgical outcomes of patients. The results of the study showed that the overall efficiency of the observer group was significantly higher than that of the control group, while intraoperative bleeding, hospital stay, time to return to normal menstruation, and time to disappearance of the gestational sac were all lower than those of the control group ( p < 0.05 ). The results of univariate and multifactorial analyses showed that endometrial inflammation, gestational week, maximum diameter of the gestational sac, thinnest myometrium, and endogenous-exogenous type could affect the patients’ postoperative recovery ( p < 0.05 ); gestational week, maximum diameter of the gestational sac, and thinnest myometrium were independent factors affecting the patients’ postoperative recovery ( p < 0.05 ). The above results suggest that UACE combined with ultrasound-guided uterine clearance for cervical pregnancy can significantly improve treatment efficacy, reduce intraoperative bleeding, and improve recovery time from postoperative related symptoms. The treatment efficacy of patients with cervical pregnancy was related to the gestational week, the maximum diameter of the gestational sac, and the thinnest muscle layer.

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Section: Discussionmentioning

confidence: 99%

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Gong¹,

Qian

Zhang³

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…Unfortunately, we failed to capture the pregnancy trends that changed over time in this way. Although the ratio/ratio calculation method used in this study has its limitations, live birth or deliveries is a suitable indicator for the comparison of EP when the number of cases enrolled increases with time [ 4 , 30 ].…”

Section: Discussionmentioning

confidence: 99%

Ectopic pregnancy in China during 2011–2020: a single-centre retrospective study of 9499 cases

Lin

Xue

et al. 2022

BMC Pregnancy Childbirth

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Background Previous studies have shown that the incidence of ectopic pregnancy (EP) is increasing in China. It is unclear, however, whether the incidence of EP has changed after the implementation of the universal two-child policy in the context of China’s aging population and declining fertility rate. Methods Data concerning EP from January 2011 to December 2020 were collected from the hospital’s electronic medical records, which included the annual number of delivery, caesarean section rate, ectopic pregnancies, treatment of tubal pregnancy, and average costs and length of hospitalization. Trends of the EP incidence were analysed and annual percentage change (APC) was calculated using connected point regression analyses. Results A total of 9499 cases of EP were collected, among which caesarean scar pregnancy (CSP) accounts for the second highest (6.73%). The EP per 100 deliveries revealed a downward trend, from 7.60% in 2011 to 4.28% in 2020 with an APC of -1.87 (P < 0.05). The maternal age was increased, especially after the implementation of the universal two-child policy. The constituent ratio for the advanced maternal age (≥ 35) and the caesarean section rate, but not the CSP, were also increased. Laparoscopic salpingectomy was the main surgical method, whereas the adoption of laparotomy and laparoscopic salpingostomy was decreasing year by year. Conclusions Although no obvious effect of the two-child policy on EP has been observed under the conditions of this study, the change in EP especially in advanced-age women after the policy implementation needs further evaluation. A decreased caesarean section rate, in primipara is beneficial to reducing the CSP.

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“…The region of the ampulla is the most frequent area where this takes place [17]. Despite early diagnosis, it causes high morbidity and mortality rates, reaching 1.4% in certain series [18].…”

Section: Ectopic Pregnancymentioning

confidence: 99%

Ectopic pregnancies and endometrial microbiota

Aguilera

García

Quevedo

2021

Current Opinion in Obstetrics &Amp; Gynecology

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In recent years there has been significant progress in the study of endometrial microbiota. This line of investigation has not been free of controversy and discussion. It is key for clinicians involved to remain updated with the most recent findings in microbiome and its clinical implications to be able to offer patients all possible treatments. Recent findingsThe existence of endometrial microbiota now seems undisputed. Current lines of work are centered on dysbiosis and its connection to other pathologies. It is in the field of assisted reproductive technology (ART) where this research plays an even more crucial role. In this case, we are focusing our attention towards the study of ectopic pregnancies (EP), searching for similarities in their etiopathogenesis and alterations in the endometrial microbiota.

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Ectopic pregnancy at the Lagos University Teaching Hospital, Lagos, South-Western Nigeria: Temporal trends, clinical presentation and management outcomes from 2005 to 2014

Cited by 10 publications

References 1 publication

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Effect of Uterine Arterial Chemoembolization Combined with Ultrasound-Guided Uterine Curettage on Cervical Pregnancy and Influencing Factors

Ectopic pregnancy in China during 2011–2020: a single-centre retrospective study of 9499 cases

Ectopic pregnancies and endometrial microbiota

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